II 

118TH CONGRESS 

2D SESSION S. 5269 

To amend title 38, United States Code, to establish a commission to review 

operations at the Veterans Health Administration and submit to Congress reports with respect to that review, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 25, 2024 

Mr. CASSIDY (for himself and Ms. HIRONO) introduced the following bill; 

which was read twice and referred to the Committee on Veterans’ Affairs 

A BILL 

To amend title 38, United States Code, to establish a commission to review operations at the Veterans Health Administration and submit to Congress reports with respect 

to that review, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘VetPAC Act of 2024’’. 


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1 SEC. 2. ESTABLISHMENT OF VETERANS HEALTH ADMINIS2 TRATION POLICY ADVISORY COMMISSION. 

3 (a) IN GENERAL.—Subchapter I of chapter 73 of title 

4 38, United States Code, is amended by adding at the end 

5 the following new section: 

6 ‘‘§ 7310B. Veterans Health Administration Policy Ad7 visory Commission 

8 ‘‘(a) ESTABLISHMENT.—There is established the Vet9 erans Health Administration Policy Advisory Commission 

10 (in this section referred to as the ‘Commission’). 

11 ‘‘(b) MEMBERSHIP.— 

12 ‘‘(1) COMPOSITION.—The Commission shall be 

13 composed of 17 members appointed by the Comp14 troller General of the United States, of which not 

15 fewer than 2 shall be veterans. 

16 ‘‘(2) QUALIFICATIONS.— 

17 ‘‘(A) IN GENERAL.—An individual is eligi18 ble for appointment to the Commission under 

19 paragraph (1) if the individual has significant 

20 expertise in operating or advising large medical 

21 systems, including expertise in quality of care, 

22 staffing issues, information technology, artificial 

23 intelligence in health care, medical supply 

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1 cility architecture or engineering, medical re2 search, and managed care plans and networks. 

3 ‘‘(B) EXPERIENCE OF MEMBERS.—In ap4 pointing members under paragraph (1), the 

5 Comptroller General shall select individuals 

6 from backgrounds that reflect the broad diver7 sity of health care received by veterans, includ8 ing nonprofit health systems, public and private 

9 health systems, care furnished by the Veterans 

10 Health Administration, and care furnished by 

11 the Department of Defense. 

12 ‘‘(3) ETHICAL DISCLOSURE.—A member of the 

13 Commission shall be considered an employee of Con14 gress whose compensation is disbursed by the Sec15 retary of the Senate for purposes of applying sub16 chapter I of chapter 131 of title 5, United States 

17 Code, except that a member of the Commission is 

18 required to file public financial disclosure reports 

19 without regard to their number of days of service or 

20 rate of pay. 

21 ‘‘(c) PERIOD OF APPOINTMENT; VACANCIES.— 

22 ‘‘(1) TERMS.—A member of the Commission 

23 shall be appointed under subsection (b)(1) for a 

24 term of 5 years, except that the Comptroller General 


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1 shall designate staggered terms for the members 

2 first appointed. 

3 ‘‘(2) VACANCIES.— 

4 ‘‘(A) IN GENERAL.—A vacancy on the 

5 Commission shall be filled in the manner in 

6 which the original appointment was made and 

7 shall be subject to any conditions that applied 

8 with respect to the original appointment. 

9 ‘‘(B) FILLING UNEXPIRED TERM.—An in10 dividual chosen to fill a vacancy shall be ap11 pointed for the unexpired term of the member 

12 replaced. 

13 ‘‘(3) EXPIRATION OF TERMS.—The term of any 

14 member shall not expire before the date on which 

15 the member’s successor takes office. 

16 ‘‘(d) MEETINGS.— 

17 ‘‘(1) FREQUENCY.—The Commission shall meet 

18 at the call of the Chairman, but not less frequently 

19 than once per year. 

20 ‘‘(2) QUORUM.—A majority of the members of 

21 the Commission shall constitute a quorum, but a 

22 lesser number of members may hold meetings. 

23 ‘‘(e) CHAIRMAN AND VICE CHAIRMAN.—The Comp24 troller General shall designate one member of the Commis25 sion as Chairman and one member of the Commission as 


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1 Vice Chairman, at the time of appointment of such mem2 ber and for the term of appointment of such member, ex3 cept that in the case of vacancy of the Chairmanship or 

4 Vice Chairmanship, the Comptroller General may des5 ignate another member for the remainder of that mem6 ber’s term. 

7 ‘‘(f) DUTIES OF THE COMMISSION.— 

8 ‘‘(1) REVIEW.—The Commission shall— 

9 ‘‘(A) review operations at the Veterans 

10 Health Administration; and 

11 ‘‘(B) prepare reports for Congress based 

12 on such review, including recommendations to 

13 Congress. 

14 ‘‘(2) TOPICS TO BE REVIEWED.—In conducting 

15 a review under paragraph (1)(A), the Commission 

16 shall include periodic reviews of the following, taking 

17 into consideration other independent assessments in 

18 selecting topics to limit duplicative efforts: 

19 ‘‘(A) Information technology infrastructure 

20 at medical facilities of the Department, includ21 ing with respect to electronic health record sys22 tems. 

23 ‘‘(B) Referrals to care at facilities of the 

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1 nity Care Program under section 1703 of this 

2 title, and factors impacting those referrals. 

3 ‘‘(C) Access and wait times at medical fa4 cilities of the Department and under the Vet5 erans Community Care Program, including both 

6 primary and specialty care, and factors impact7 ing those wait times. 

8 ‘‘(D) The quality of health care furnished 

9 by the Department and through the Veterans 

10 Community Care Program. 

11 ‘‘(E) Workforce issues, including workforce 

12 performance, recruitment, and retention fac13 tors. 

14 ‘‘(F) Patient satisfaction and customer 

15 service at medical facilities of the Department 

16 and through the Veterans Community Care 

17 Program. 

18 ‘‘(G) The training of health care providers 

19 and the standards of care at facilities of the 

20 Department and in the Veterans Community 

21 Care Program. 

22 ‘‘(H) The long-term budgetary outlook of 

23 the Veterans Health Administration, as well as 

24 key components driving budgetary changes over 

25 time. 


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1 ‘‘(I) Procurement of supplies at medical fa2 cilities of the Department. 

3 ‘‘(J) The research program of the Depart4 ment, including both internal and external re5 search. 

6 ‘‘(K) Hospital construction, leasing, and 

7 capital requirements. 

8 ‘‘(L) The interaction of care under the 

9 Medicare program under title XVIII of the So10 cial Security Act (42 U.S.C. 1395 et seq.), the 

11 Medicaid program under title XIX of such Act 

12 (42 U.S.C. 1396 et seq.), the TRICARE pro13 gram under chapter 55 of title 10, and commer14 cial health care plans with care furnished by the 

15 Veterans Health Administration. 

16 ‘‘(3) ISSUES REGARDING VETERAN HEALTH

17 CARE DELIVERY GENERALLY.—In carrying out the 

18 requirements of this subsection, the Commission 

19 shall review the effect of policies under this title on 

20 the delivery of health care services to veterans and 

21 assess the implications of changes in health care de22 livery for veterans in the United States. 

23 ‘‘(4) TRANSMITTAL OF CERTAIN REPORTS.—If 

24 the Secretary or the Inspector General of the De25 partment of Veterans Affairs submits to Congress 


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1 (or a committee of Congress) a report that is re2 quired by law and that relates to policies for health 

3 care furnished under the laws administered by the 

4 Secretary, the Secretary shall transmit a copy of 

5 that report to the Commission. 

6 ‘‘(5) CONSULTATION AND ADDITIONAL REVIEWS

7 AND STUDIES.— 

8 ‘‘(A) CONSULTATION.—In carrying out the 

9 requirements of this subsection, the Commis10 sion shall consult periodically with the chairmen 

11 and ranking members of the Committee on Vet12 erans’ Affairs of the Senate and the Committee 

13 on Veterans’ Affairs of the House of Represent14 atives regarding the agenda of the Commission 

15 and progress towards achieving that agenda. 

16 ‘‘(B) ADDITIONAL REVIEWS AND RE17 PORTS.—The Commission may conduct addi18 tional reviews, and may submit additional re19 ports to the Committee on Veterans’ Affairs of 

20 the Senate and the Committee on Veterans’ Af21 fairs of the House of Representatives, from 

22 time to time on such topics relating to the ac23 tivities of the Commission as may be requested 

24 by the Chairman and members and as the Com25 mission determines appropriate. 


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1 ‘‘(C) SPECIAL STUDIES.—The Commission 

2 may conduct special studies requested by the 

3 chairman or ranking member of the Committee 

4 on Veterans’ Affairs of the Senate or the Com5 mittee on Veterans’ Affairs of the House of 

6 Representatives and as the Commission deter7 mines appropriate. 

8 ‘‘(6) BUDGETARY CONSIDERATIONS.—Before 

9 making any recommendations to Congress, the Com10 mission shall examine the budget consequences of 

11 such recommendations, directly or through consulta12 tion with appropriate expert entities. 

13 ‘‘(7) REPORT.— 

14 ‘‘(A) IN GENERAL.—By not later than 

15 March 15 of each year, the Commission shall 

16 submit to Congress a report containing the re17 sults and recommendations from the review 

18 conducted under paragraph (1). 

19 ‘‘(B) INCLUSION OF RECOMMENDA20 TIONS.—A recommendation may be included in 

21 a report under subparagraph (A) if a simple 

22 majority of the members of the Commission 

23 vote to include the recommendation in the re24 port. 

25 ‘‘(g) POWERS OF COMMISSION.— 


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1 ‘‘(1) IN GENERAL.—The Commission may— 

2 ‘‘(A) employ and fix the compensation of 

3 an Executive Director (at a rate of pay not 

4 greater than that provided for level III of the 

5 Executive Schedule under section 5314 of title 

6 5) and such other personnel as may be nec7 essary to carry out the duties of the Commis8 sion, without regard to the provisions of title 5 

9 governing appointments in the competitive serv10 ice; 

11 ‘‘(B) seek such assistance and support as 

12 may be required in the performance of its du13 ties from appropriate departments and agencies 

14 of the United States or departments or agencies 

15 of a State; 

16 ‘‘(C) enter into contracts or make other ar17 rangements, as may be necessary for the con18 duct of the work of the Commission (without 

19 regard to section 3709 of the Revised Statutes 

20 (41 U.S.C. 5)); 

21 ‘‘(D) make advance, progress, and other 

22 payments that relate to the work of the Com23 mission; 


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1 ‘‘(E) provide transportation and subsist2 ence for individuals serving the Commission 

3 without compensation; and 

4 ‘‘(F) prescribe such rules and regulations 

5 as the Commission determines necessary with 

6 respect to the internal organization and oper7 ation of the Commission. 

8 ‘‘(2) DATA COLLECTION.—In order to carry out 

9 its functions, the Commission shall— 

10 ‘‘(A) utilize existing information, both pub11 lished and unpublished, if possible, collected 

12 and assessed either by its own staff or under 

13 other arrangements made in accordance with 

14 this section; 

15 ‘‘(B) carry out, or award grants or con16 tracts for, original research and experimen17 tation, if existing information is inadequate; 

18 and 

19 ‘‘(C) adopt procedures allowing any inter20 ested party to submit information for use by 

21 the Commission in making reports and rec22 ommendations. 

23 ‘‘(3) INFORMATION FROM FEDERAL AGEN24 CIES.— 


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1 ‘‘(A) IN GENERAL.—The Commission may 

2 secure directly from any relevant department or 

3 agency of the United States health care infor4 mation the Chairman determines would be help5 ful to enable the Commission to carry out this 

6 section. 

7 ‘‘(B) TIMING.—Upon request of the Chair8 man, the head of a department or agency of the 

9 United States shall furnish information re10 quested under subparagraph (A) to the Com11 mission on an agreed upon schedule or not later 

12 than 180 days after the date of the request. 

13 ‘‘(h) COMPENSATION.— 

14 ‘‘(1) MEMBERS.— 

15 ‘‘(A) IN GENERAL.—While conducting the 

16 business of the Commission (including travel 

17 time), a member of the Commission shall be en18 titled to compensation at the per diem equiva19 lent of the rate provided for level IV of the Ex20 ecutive Schedule under section 5315 of title 5. 

21 ‘‘(B) TRAVEL EXPENSES.—While con22 ducting the business of the Commission away 

23 from home and the regular place of business of 

24 the member, a member may be allowed travel 

25 expenses, as authorized by the Chairman. 


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1 ‘‘(2) PHYSICIAN COMPARABILITY ALLOWANCE

2 FOR PERSONNEL.—The Commission may provide a 

3 physician comparability allowance to physicians serv4 ing as personnel of the Commission in the same 

5 manner as physicians of the Federal Government 

6 may be provided such an allowance by an agency 

7 under section 5948 of title 5, and for such purpose, 

8 subsection (i) of such section shall apply to the Com9 mission in the same manner as it applies to the Ten10 nessee Valley Authority. 

11 ‘‘(3) TREATMENT OF PERSONNEL.—For pur12 poses of pay (other than pay of members of the 

13 Commission) and employment benefits, rights, and 

14 privileges, all personnel of the Commission shall be 

15 treated as if they were employees of the United 

16 States Senate. 

17 ‘‘(i) DETAIL OF FEDERAL EMPLOYEES.—An em18 ployee of the Federal Government may be detailed to the 

19 Commission without reimbursement and without interrup20 tion or loss of civil service status or privileges. 

21 ‘‘(j) ACCESS OF CONGRESSIONAL SUPPORT AGEN22 CIES TO INFORMATION.—The Commission shall provide to 

23 the Comptroller General, the Congressional Research 

24 Service, and the Congressional Budget Office unrestricted 

25 access to all deliberations, records, and nonproprietary 


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1 data of the Commission not later than 30 days after such 

2 access is requested. 

3 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.— 

4 ‘‘(1) REQUEST FOR APPROPRIATIONS.—The 

5 Commission shall submit requests for appropriations 

6 in the same manner as the Comptroller General sub7 mits requests for appropriations, but amounts ap8 propriated for the Commission shall be separate 

9 from amounts appropriated for the Comptroller Gen10 eral. 

11 ‘‘(2) AUTHORIZATION.—There are authorized to 

12 be appropriated such sums as may be necessary to 

13 carry out this section.’’. 

14 (b) CLERICAL AMENDMENT.—The table of sections 

15 at the beginning of such chapter is amended by inserting 

16 after the item relating to section 7310A the following new 

17 item: 

‘‘7310B. Veterans Health Administration Policy Advisory Commission.’’. 

18 (c) INITIAL APPOINTMENT.—Not later than 280 days 

19 after the date on which amounts are first appropriated 

20 to the Veterans Health Administration Policy Advisory 

21 Commission established under section 7310B of title 38, 

22 United States Code, as added by subsection (a), the 

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1 tial appointments of members to the Commission under 

2 subsection (b)(1) of such section. 

Æ 


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